ObjectiveTo explore the efficacy and mechanisms of Sini San in the treatment of depression and liver injury based on gut microbiota. MethodsThirty-two male Sprague-Dawley （SD） rats were randomly divided into a normal group， model group （M）， Sini San group （MS， 2.5 g·kg^-1）， and fluoxetine group （MF， 2 mg·kg^-1）. Except for the normal group， rats in the other three groups were subjected to chronic unpredictable mild stress （CUMS）. After 8 weeks， the open-field test and sucrose preference test were conducted. Enzyme-linked immunosorbent assay （ELISA） was used to detect serum corticosterone （CORT）， adrenocorticotropic hormone （ACTH）， corticotropin-releasing factor （CRF）， lipopolysaccharide （LPS）， Zonulin， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， γ-aminobutyric acid （GABA） levels in the hippocampus and prefrontal cortex， and brain-derived neurotrophic factor （BDNF） levels in the hippocampus. Real-time quantitative polymerase chain reaction （Real-time PCR） was used to detect hippocampal BDNF mRNA expression. Serum alanine aminotransferase （ALT） and aspartate aminotransferase （AST） levels were measured using the ultraviolet lactate dehydrogenase method. The ultrastructure of the intestinal epithelium was observed by electron microscopy， and gut microbiota in rat feces were analyzed using 16S rDNA high-throughput sequencing. ResultsCompared with the normal group， the sucrose preference of rats in the model group was significantly reduced （P0.01）， whereas it was significantly increased in the Sini San group compared with the model group （P0.05）. Compared with the normal group， hippocampal GABA protein levels and BDNF mRNA expression in the model group were significantly decreased （P0.05）， and compared with the model group， both were significantly increased in the Sini San group （P0.05， P0.01）. Compared with the normal group， serum LPS and Zonulin levels in the model group were significantly increased （P0.05， P0.01）， and compared with the model group， Zonulin levels in the Sini San group were significantly decreased （P0.05）. No obvious changes were observed in the ultrastructure of the jejunal mucosa among groups. Compared with the normal group， widened and blurred tight junctions， sparse and shortened microvilli， and mitochondrial swelling with cristae disruption in epithelial cells were observed in the ileal and colonic mucosa of the model group， which were markedly improved in the Sini San and fluoxetine groups. The results of 16S rDNA high-throughput sequencing showed that Sini San improved CUMS-induced dysbiosis of Bacteroidetes and Proteobacteria. Correlation analysis indicated that Bacteroidetes and Proteobacteria were significantly correlated with depression-related indicators， liver function， and intestinal mucosal permeability. ConclusionSini San exerts antidepressant and hepatoprotective effects by improving Bacteroidetes and Proteobacteria and inhibiting the increase in intestinal mucosal permeability in CUMS rats.

ObjectiveTo explore the efficacy and mechanisms of Sini San in the treatment of depression and liver injury based on gut microbiota. MethodsThirty-two male Sprague-Dawley （SD） rats were randomly divided into a normal group， model group （M）， Sini San group （MS， 2.5 g·kg^-1）， and fluoxetine group （MF， 2 mg·kg^-1）. Except for the normal group， rats in the other three groups were subjected to chronic unpredictable mild stress （CUMS）. After 8 weeks， the open-field test and sucrose preference test were conducted. Enzyme-linked immunosorbent assay （ELISA） was used to detect serum corticosterone （CORT）， adrenocorticotropic hormone （ACTH）， corticotropin-releasing factor （CRF）， lipopolysaccharide （LPS）， Zonulin， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， γ-aminobutyric acid （GABA） levels in the hippocampus and prefrontal cortex， and brain-derived neurotrophic factor （BDNF） levels in the hippocampus. Real-time quantitative polymerase chain reaction （Real-time PCR） was used to detect hippocampal BDNF mRNA expression. Serum alanine aminotransferase （ALT） and aspartate aminotransferase （AST） levels were measured using the ultraviolet lactate dehydrogenase method. The ultrastructure of the intestinal epithelium was observed by electron microscopy， and gut microbiota in rat feces were analyzed using 16S rDNA high-throughput sequencing. ResultsCompared with the normal group， the sucrose preference of rats in the model group was significantly reduced （P<0.01）， whereas it was significantly increased in the Sini San group compared with the model group （P<0.05）. Compared with the normal group， hippocampal GABA protein levels and BDNF mRNA expression in the model group were significantly decreased （P<0.05）， and compared with the model group， both were significantly increased in the Sini San group （P<0.05， P<0.01）. Compared with the normal group， serum LPS and Zonulin levels in the model group were significantly increased （P<0.05， P<0.01）， and compared with the model group， Zonulin levels in the Sini San group were significantly decreased （P<0.05）. No obvious changes were observed in the ultrastructure of the jejunal mucosa among groups. Compared with the normal group， widened and blurred tight junctions， sparse and shortened microvilli， and mitochondrial swelling with cristae disruption in epithelial cells were observed in the ileal and colonic mucosa of the model group， which were markedly improved in the Sini San and fluoxetine groups. The results of 16S rDNA high-throughput sequencing showed that Sini San improved CUMS-induced dysbiosis of Bacteroidetes and Proteobacteria. Correlation analysis indicated that Bacteroidetes and Proteobacteria were significantly correlated with depression-related indicators， liver function， and intestinal mucosal permeability. ConclusionSini San exerts antidepressant and hepatoprotective effects by improving Bacteroidetes and Proteobacteria and inhibiting the increase in intestinal mucosal permeability in CUMS rats.

Objective:To explore the application value of uterine net-like compression suture in postpartum hemorrhage(PPH).Methods:The data of 84 refractory PPH patients from six hospitals specialized in children and women in Chengdu from January 2015 to March 2023 were retrospectively analyzed.They were divided into two groups according to the surgical methods:41 cases of B-Lynch suture(control group)and 43 cases of uterine net-like compression suture(observation group).The clinical efficacy of the two methods was observed,and the perioperative indicators and clinical outcomes were compared between the two groups.Results:①31 cases in the control group and 42 cases in the observation group,were successfully hemostatic and retained the uterus,with effective rates of 75.61%and 97.67%,respectively.The difference was statistically significant(P＜0.01).②There were no significant differences in the rates of all preoperative diagnosis and preoperative blood loss between the two groups(P＞0.05);in the observation group,the intraoperative and 2 h postoperative blood loss,the units of postoperative blood transfusion,the incidence rate of requiring postoperative intensive care and the hospitalization days,were less than those in the control group(P＜0.01).③During a follow-up period of 10-48 months,all 73 pa-tients without hysterectomy recovered menstrual cycles within 12 months after the surgery.Thirteen cases experi-enced reduced menstrual flow with cycle changes in the control group(41.94%),while 6 cases experienced in the observation group(14.29%),and the difference was statistically significant(P＜0.01);5 cases(16.13%)had sub-sequent pregnancy in the control group,while 12 cases(28.57%)had in the other,with no significant difference(P＞0.05).Conclusions:The two uterine sutures for refractory PPH have both achieved good clinical curative effects,and the uterine net-like compression suture shows therapeutic advantages on intraoperative and postoper-ative blood loss,postoperative blood transfusion,and hospitalization days.The uterine net-like compression suture has no special requirements for medical devices or materials,and thus has important popularization and applica-tion value for primary obstetrics with limited medical conditions.

BACKGROUND:Some studies have shown that the hounsfield units(HU)value based on lumbar CT can be used to screen osteoporosis.At present,the number of patients with pulmonary infection has increased;the number of patients with pulmonary infection and type 2 diabetes is also increasing,which increases the utilization rate of chest CT. OBJECTIVE:To investigate the role of lumbar 1 vertebral body HU value based on chest CT in the screening of type 2 diabetes mellitus osteoporosis. METHODS:The clinical data of 244 patients with type 2 diabetes mellitus treated in the First Affiliated Hospital of Chengdu Medical College from June 2020 to June 2022 were analyzed retrospectively.The bone mineral density was obtained by dual-energy X-ray absorptiometry.According to WHO's diagnostic criteria for osteoporosis,the subjects were divided into the non-osteoporosis group(n=120)and the osteoporosis group(n=124).The general condition,T value and HU value of lumbar 1 vertebra in chest CT were compared,and the relationship between the HU value and T value of each position was analyzed and the accuracy of type 2 diabetes mellitus osteoporosis was evaluated. RESULTS AND CONCLUSION:(1)There was no significant difference in sex,age,body mass index,glycosylated hemoglobin,mean blood glucose,calcium(Ca),phosphorus(P),time of type 2 diabetes mellitus,history of hypertension and history of hyperlipidemia between the two groups(P>0.05).(2)The HU value was positively correlated with the lowest T value of the hip(r=0.619,P<0.01);the HU value was positively correlated with the hip T value(r=0.584,P<0.01),and the HU value was positively correlated with the femoral neck T value(r=0.641,P<0.01).When the HU value was 98,the prediction of type 2 diabetes mellitus osteoporosis had good accuracy,and the sensitivity was 70.8%.(3)It is concluded that the HU value of the lumbar 1 vertebra based on chest CT examination is of good value for osteoporosis screening in patients with type 2 diabetes mellitus,and may be an opportunistic and cost-free supplementary screening method for type 2 diabetes mellitus osteoporosis.

Objective To explore the intrinsic relationship between circadian clock and cell cycle in osteoarthritis(OA)chondrocytes,especially the regulation of cell cycle-related genes by the clock gene Bmal1.Methods The chondroid ATDC5 cells induced by insulin-transfering-selenium(ITS)were divided into control group,OA group and LV-Bmal1 group.The cell viability of each group was detected by CCK8 method.The expression of Bmal1,Per1,Wee1,Cdk1,Ccnb1 and Mmp13 mRNA in each group was detected by RT-qPCR.The expression of BMAL1,PER1,WEE1,CDK1,CCNB1 and MMP13 protein in each group was detected by Western blot.The effects of Bmal1 on different stages of cell cycle and apoptosis was analyzed by flow cytometry.The regulation of Bmal1 on Per1,Wee1,Cdk1,Ccnb1 and Mmp13 and their roles in OA were analyzed.Results Compared with the normal group,the cell viability of the OA group was increased,the relative mRNA expression of Bmal1 and Wee1 in the OA group decreased,and the relative mRNA expression of Per1,Cdk1,Ccnb1 and Mmp13 increased signif-icantly.The cell viability of LV-Bmal1 group decreased,the relative expression of Bmal1 and Wee1 mRNA in-creased,and the relative expression of Per1,Cdk1,Ccnb1 and Mmp13 mRNA decreased(P＜0.05).Correlation analysis showed that Bmal1 was positively correlated with Wee1 and they were negatively correlated with Per1,Cdk1,Ccnb1 or Mmp13.The results of Western blot showed that protein expression in different groups were con-sistent with the trend of PCR.The results of cell cycle and apoptosis showed that compared with the normal group,the S phase and G2/M phase of the OA group were shortened,the proportion of cells decreased significantly,and the proportion of early and late apoptosis increased.The S phase and G2/M phase of the LV-Bmal1 group were prolonged,the proportion of cells was increased,and the proportion of early and late apoptosis was decreased.Conclusions Circadian clock gene Bmal1 in inflammatory chondrocytes might regulate the expression of cell cycle-related genes.

Objective:To explore the application value of uterine net-like compression suture in postpartum hemorrhage(PPH).Methods:The data of 84 refractory PPH patients from six hospitals specialized in children and women in Chengdu from January 2015 to March 2023 were retrospectively analyzed.They were divided into two groups according to the surgical methods:41 cases of B-Lynch suture(control group)and 43 cases of uterine net-like compression suture(observation group).The clinical efficacy of the two methods was observed,and the perioperative indicators and clinical outcomes were compared between the two groups.Results:①31 cases in the control group and 42 cases in the observation group,were successfully hemostatic and retained the uterus,with effective rates of 75.61%and 97.67%,respectively.The difference was statistically significant(P＜0.01).②There were no significant differences in the rates of all preoperative diagnosis and preoperative blood loss between the two groups(P＞0.05);in the observation group,the intraoperative and 2 h postoperative blood loss,the units of postoperative blood transfusion,the incidence rate of requiring postoperative intensive care and the hospitalization days,were less than those in the control group(P＜0.01).③During a follow-up period of 10-48 months,all 73 pa-tients without hysterectomy recovered menstrual cycles within 12 months after the surgery.Thirteen cases experi-enced reduced menstrual flow with cycle changes in the control group(41.94%),while 6 cases experienced in the observation group(14.29%),and the difference was statistically significant(P＜0.01);5 cases(16.13%)had sub-sequent pregnancy in the control group,while 12 cases(28.57%)had in the other,with no significant difference(P＞0.05).Conclusions:The two uterine sutures for refractory PPH have both achieved good clinical curative effects,and the uterine net-like compression suture shows therapeutic advantages on intraoperative and postoper-ative blood loss,postoperative blood transfusion,and hospitalization days.The uterine net-like compression suture has no special requirements for medical devices or materials,and thus has important popularization and applica-tion value for primary obstetrics with limited medical conditions.

Objective:To explore the application value of uterine net-like compression suture in postpartum hemorrhage(PPH).Methods:The data of 84 refractory PPH patients from six hospitals specialized in children and women in Chengdu from January 2015 to March 2023 were retrospectively analyzed.They were divided into two groups according to the surgical methods:41 cases of B-Lynch suture(control group)and 43 cases of uterine net-like compression suture(observation group).The clinical efficacy of the two methods was observed,and the perioperative indicators and clinical outcomes were compared between the two groups.Results:①31 cases in the control group and 42 cases in the observation group,were successfully hemostatic and retained the uterus,with effective rates of 75.61%and 97.67%,respectively.The difference was statistically significant(P＜0.01).②There were no significant differences in the rates of all preoperative diagnosis and preoperative blood loss between the two groups(P＞0.05);in the observation group,the intraoperative and 2 h postoperative blood loss,the units of postoperative blood transfusion,the incidence rate of requiring postoperative intensive care and the hospitalization days,were less than those in the control group(P＜0.01).③During a follow-up period of 10-48 months,all 73 pa-tients without hysterectomy recovered menstrual cycles within 12 months after the surgery.Thirteen cases experi-enced reduced menstrual flow with cycle changes in the control group(41.94%),while 6 cases experienced in the observation group(14.29%),and the difference was statistically significant(P＜0.01);5 cases(16.13%)had sub-sequent pregnancy in the control group,while 12 cases(28.57%)had in the other,with no significant difference(P＞0.05).Conclusions:The two uterine sutures for refractory PPH have both achieved good clinical curative effects,and the uterine net-like compression suture shows therapeutic advantages on intraoperative and postoper-ative blood loss,postoperative blood transfusion,and hospitalization days.The uterine net-like compression suture has no special requirements for medical devices or materials,and thus has important popularization and applica-tion value for primary obstetrics with limited medical conditions.

Objective:To explore the application value of uterine net-like compression suture in postpartum hemorrhage(PPH).Methods:The data of 84 refractory PPH patients from six hospitals specialized in children and women in Chengdu from January 2015 to March 2023 were retrospectively analyzed.They were divided into two groups according to the surgical methods:41 cases of B-Lynch suture(control group)and 43 cases of uterine net-like compression suture(observation group).The clinical efficacy of the two methods was observed,and the perioperative indicators and clinical outcomes were compared between the two groups.Results:①31 cases in the control group and 42 cases in the observation group,were successfully hemostatic and retained the uterus,with effective rates of 75.61%and 97.67%,respectively.The difference was statistically significant(P＜0.01).②There were no significant differences in the rates of all preoperative diagnosis and preoperative blood loss between the two groups(P＞0.05);in the observation group,the intraoperative and 2 h postoperative blood loss,the units of postoperative blood transfusion,the incidence rate of requiring postoperative intensive care and the hospitalization days,were less than those in the control group(P＜0.01).③During a follow-up period of 10-48 months,all 73 pa-tients without hysterectomy recovered menstrual cycles within 12 months after the surgery.Thirteen cases experi-enced reduced menstrual flow with cycle changes in the control group(41.94%),while 6 cases experienced in the observation group(14.29%),and the difference was statistically significant(P＜0.01);5 cases(16.13%)had sub-sequent pregnancy in the control group,while 12 cases(28.57%)had in the other,with no significant difference(P＞0.05).Conclusions:The two uterine sutures for refractory PPH have both achieved good clinical curative effects,and the uterine net-like compression suture shows therapeutic advantages on intraoperative and postoper-ative blood loss,postoperative blood transfusion,and hospitalization days.The uterine net-like compression suture has no special requirements for medical devices or materials,and thus has important popularization and applica-tion value for primary obstetrics with limited medical conditions.

Objective:To explore the application value of uterine net-like compression suture in postpartum hemorrhage(PPH).Methods:The data of 84 refractory PPH patients from six hospitals specialized in children and women in Chengdu from January 2015 to March 2023 were retrospectively analyzed.They were divided into two groups according to the surgical methods:41 cases of B-Lynch suture(control group)and 43 cases of uterine net-like compression suture(observation group).The clinical efficacy of the two methods was observed,and the perioperative indicators and clinical outcomes were compared between the two groups.Results:①31 cases in the control group and 42 cases in the observation group,were successfully hemostatic and retained the uterus,with effective rates of 75.61%and 97.67%,respectively.The difference was statistically significant(P＜0.01).②There were no significant differences in the rates of all preoperative diagnosis and preoperative blood loss between the two groups(P＞0.05);in the observation group,the intraoperative and 2 h postoperative blood loss,the units of postoperative blood transfusion,the incidence rate of requiring postoperative intensive care and the hospitalization days,were less than those in the control group(P＜0.01).③During a follow-up period of 10-48 months,all 73 pa-tients without hysterectomy recovered menstrual cycles within 12 months after the surgery.Thirteen cases experi-enced reduced menstrual flow with cycle changes in the control group(41.94%),while 6 cases experienced in the observation group(14.29%),and the difference was statistically significant(P＜0.01);5 cases(16.13%)had sub-sequent pregnancy in the control group,while 12 cases(28.57%)had in the other,with no significant difference(P＞0.05).Conclusions:The two uterine sutures for refractory PPH have both achieved good clinical curative effects,and the uterine net-like compression suture shows therapeutic advantages on intraoperative and postoper-ative blood loss,postoperative blood transfusion,and hospitalization days.The uterine net-like compression suture has no special requirements for medical devices or materials,and thus has important popularization and applica-tion value for primary obstetrics with limited medical conditions.

Objective:To explore the application value of uterine net-like compression suture in postpartum hemorrhage(PPH).Methods:The data of 84 refractory PPH patients from six hospitals specialized in children and women in Chengdu from January 2015 to March 2023 were retrospectively analyzed.They were divided into two groups according to the surgical methods:41 cases of B-Lynch suture(control group)and 43 cases of uterine net-like compression suture(observation group).The clinical efficacy of the two methods was observed,and the perioperative indicators and clinical outcomes were compared between the two groups.Results:①31 cases in the control group and 42 cases in the observation group,were successfully hemostatic and retained the uterus,with effective rates of 75.61%and 97.67%,respectively.The difference was statistically significant(P＜0.01).②There were no significant differences in the rates of all preoperative diagnosis and preoperative blood loss between the two groups(P＞0.05);in the observation group,the intraoperative and 2 h postoperative blood loss,the units of postoperative blood transfusion,the incidence rate of requiring postoperative intensive care and the hospitalization days,were less than those in the control group(P＜0.01).③During a follow-up period of 10-48 months,all 73 pa-tients without hysterectomy recovered menstrual cycles within 12 months after the surgery.Thirteen cases experi-enced reduced menstrual flow with cycle changes in the control group(41.94%),while 6 cases experienced in the observation group(14.29%),and the difference was statistically significant(P＜0.01);5 cases(16.13%)had sub-sequent pregnancy in the control group,while 12 cases(28.57%)had in the other,with no significant difference(P＞0.05).Conclusions:The two uterine sutures for refractory PPH have both achieved good clinical curative effects,and the uterine net-like compression suture shows therapeutic advantages on intraoperative and postoper-ative blood loss,postoperative blood transfusion,and hospitalization days.The uterine net-like compression suture has no special requirements for medical devices or materials,and thus has important popularization and applica-tion value for primary obstetrics with limited medical conditions.